Time to recognition, aetiology, antibiotic sensitivity pattern and outcome of sepsis (sepsis 2 definition) in a tertiary care hospital in Sri Lanka
<p><strong>Introduction</strong>: Patients with sepsis or severe sepsis usually present to the Emergency Department (ED). The overall mortality rate for patients admitted with severe sepsis is 35% - approximately five times higher than that of ST-elevation myocardial infarction. Pr...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sri Lankan Society for Microbiology
2022-04-01
|
| Series: | Sri Lankan Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | https://sljid.sljol.info/articles/8432 |
| _version_ | 1811231900201648128 |
|---|---|
| author | MMPT Jayasekera NDP De Costa WMMKB Gunarathne MCJ Senarathne KMS Malkanthi |
| author_facet | MMPT Jayasekera NDP De Costa WMMKB Gunarathne MCJ Senarathne KMS Malkanthi |
| author_sort | MMPT Jayasekera |
| collection | DOAJ |
| description | <p><strong>Introduction</strong>: Patients with sepsis or severe sepsis usually present to the Emergency Department (ED). The overall mortality rate for patients admitted with severe sepsis is 35% - approximately five times higher than that of ST-elevation myocardial infarction. Prompt recognition and treatment are essential to improve survival. Our aim was to study the time to recognition, identify aetiology, and obtain antibiotic sensitivity patterns and outcome of patients presenting with suspected sepsis.</p><p> </p><p><strong>Methodology:</strong> A prospective observational study including all patients suspected of having sepsis was carried out from July 1, 2016, to June 30, 2017, at the Emergency Department (ED) of the Provincial General Hospital Kurunegala, Sri Lanka. The study instrument was a data sheet comprising of the surviving sepsis guidelines (Sepsis 2) of the United Kingdom and demographics and background information from patient records. All the patients were followed up for one month.</p><p> </p><p><strong>Results:</strong> One hundred and four patients (Age:61 ±17, 54.8% males) were studied. Blood culture results were available in 94 patients (90.4%) of which 19 (20%) were positive. The most common organisms identified were coagulase-negative <em>Staphylococcus</em> (CoNS) (42%) and <em>Escherichia coli </em>(42%). Door to blood culture time was 38.6 ± 26.7 minutes with 98% having blood cultures taken within 45 minutes of admission. Door to antibiotic time was 43.3 ±27.2 minutes. The most common primary foci of infection were pneumonia (34.6%) and cellulitis (28.8%). All CoNS were sensitive to teicoplanin and vancomycin, while all <em>Escherichia coli</em> isolates were sensitive to meropenem. The median (IQR) duration of hospital stay was 6 (3 to 9.1) days.</p><p> </p><p>The in-hospital mortality was 30 (28.9%) and 30-day mortality was 36 (34.6%). There was no statistical significance regarding mortality among blood culture positive and negative patients.</p><p> </p><p><strong>Conclusion:</strong> The sepsis bundle had been activated within 45 minutes in most of our patients. The outcome of sepsis at our hospital is better than data published from other centres around the world.</p> |
| first_indexed | 2024-04-12T10:52:50Z |
| format | Article |
| id | doaj.art-fbedc73e57a44310bec649415e3d6588 |
| institution | Directory Open Access Journal |
| issn | 2012-8169 2448-9654 |
| language | English |
| last_indexed | 2024-04-12T10:52:50Z |
| publishDate | 2022-04-01 |
| publisher | Sri Lankan Society for Microbiology |
| record_format | Article |
| series | Sri Lankan Journal of Infectious Diseases |
| spelling | doaj.art-fbedc73e57a44310bec649415e3d65882022-12-22T03:36:10ZengSri Lankan Society for MicrobiologySri Lankan Journal of Infectious Diseases2012-81692448-96542022-04-0112111110.4038/sljid.v12i1.84325955Time to recognition, aetiology, antibiotic sensitivity pattern and outcome of sepsis (sepsis 2 definition) in a tertiary care hospital in Sri LankaMMPT Jayasekera0NDP De Costa1WMMKB Gunarathne2MCJ Senarathne3KMS Malkanthi4General Sir John Kotelawala Defence UniversityTeaching Hospital KurunegalaTeaching Hospital KurunegalaTeaching Hospital KurunegalaTeaching Hospital Kurunegala<p><strong>Introduction</strong>: Patients with sepsis or severe sepsis usually present to the Emergency Department (ED). The overall mortality rate for patients admitted with severe sepsis is 35% - approximately five times higher than that of ST-elevation myocardial infarction. Prompt recognition and treatment are essential to improve survival. Our aim was to study the time to recognition, identify aetiology, and obtain antibiotic sensitivity patterns and outcome of patients presenting with suspected sepsis.</p><p> </p><p><strong>Methodology:</strong> A prospective observational study including all patients suspected of having sepsis was carried out from July 1, 2016, to June 30, 2017, at the Emergency Department (ED) of the Provincial General Hospital Kurunegala, Sri Lanka. The study instrument was a data sheet comprising of the surviving sepsis guidelines (Sepsis 2) of the United Kingdom and demographics and background information from patient records. All the patients were followed up for one month.</p><p> </p><p><strong>Results:</strong> One hundred and four patients (Age:61 ±17, 54.8% males) were studied. Blood culture results were available in 94 patients (90.4%) of which 19 (20%) were positive. The most common organisms identified were coagulase-negative <em>Staphylococcus</em> (CoNS) (42%) and <em>Escherichia coli </em>(42%). Door to blood culture time was 38.6 ± 26.7 minutes with 98% having blood cultures taken within 45 minutes of admission. Door to antibiotic time was 43.3 ±27.2 minutes. The most common primary foci of infection were pneumonia (34.6%) and cellulitis (28.8%). All CoNS were sensitive to teicoplanin and vancomycin, while all <em>Escherichia coli</em> isolates were sensitive to meropenem. The median (IQR) duration of hospital stay was 6 (3 to 9.1) days.</p><p> </p><p>The in-hospital mortality was 30 (28.9%) and 30-day mortality was 36 (34.6%). There was no statistical significance regarding mortality among blood culture positive and negative patients.</p><p> </p><p><strong>Conclusion:</strong> The sepsis bundle had been activated within 45 minutes in most of our patients. The outcome of sepsis at our hospital is better than data published from other centres around the world.</p>https://sljid.sljol.info/articles/8432sepsis, early recognition, antibiotic sensitivity, emergency department, sri lanka |
| spellingShingle | MMPT Jayasekera NDP De Costa WMMKB Gunarathne MCJ Senarathne KMS Malkanthi Time to recognition, aetiology, antibiotic sensitivity pattern and outcome of sepsis (sepsis 2 definition) in a tertiary care hospital in Sri Lanka Sri Lankan Journal of Infectious Diseases sepsis, early recognition, antibiotic sensitivity, emergency department, sri lanka |
| title | Time to recognition, aetiology, antibiotic sensitivity pattern and outcome of sepsis (sepsis 2 definition) in a tertiary care hospital in Sri Lanka |
| title_full | Time to recognition, aetiology, antibiotic sensitivity pattern and outcome of sepsis (sepsis 2 definition) in a tertiary care hospital in Sri Lanka |
| title_fullStr | Time to recognition, aetiology, antibiotic sensitivity pattern and outcome of sepsis (sepsis 2 definition) in a tertiary care hospital in Sri Lanka |
| title_full_unstemmed | Time to recognition, aetiology, antibiotic sensitivity pattern and outcome of sepsis (sepsis 2 definition) in a tertiary care hospital in Sri Lanka |
| title_short | Time to recognition, aetiology, antibiotic sensitivity pattern and outcome of sepsis (sepsis 2 definition) in a tertiary care hospital in Sri Lanka |
| title_sort | time to recognition aetiology antibiotic sensitivity pattern and outcome of sepsis sepsis 2 definition in a tertiary care hospital in sri lanka |
| topic | sepsis, early recognition, antibiotic sensitivity, emergency department, sri lanka |
| url | https://sljid.sljol.info/articles/8432 |
| work_keys_str_mv | AT mmptjayasekera timetorecognitionaetiologyantibioticsensitivitypatternandoutcomeofsepsissepsis2definitioninatertiarycarehospitalinsrilanka AT ndpdecosta timetorecognitionaetiologyantibioticsensitivitypatternandoutcomeofsepsissepsis2definitioninatertiarycarehospitalinsrilanka AT wmmkbgunarathne timetorecognitionaetiologyantibioticsensitivitypatternandoutcomeofsepsissepsis2definitioninatertiarycarehospitalinsrilanka AT mcjsenarathne timetorecognitionaetiologyantibioticsensitivitypatternandoutcomeofsepsissepsis2definitioninatertiarycarehospitalinsrilanka AT kmsmalkanthi timetorecognitionaetiologyantibioticsensitivitypatternandoutcomeofsepsissepsis2definitioninatertiarycarehospitalinsrilanka |